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Item Recommendations for the selection of techniques and components used in congenital heart surgery in Turkey(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012-01-01) Undar, Akif; Haydin, Sertac; Erek, Ersin; Yivli, Perihan; Odemis, Ender; Agirbasli, Mehmet; Alkan-Bozkaya, Tijen; Turkoz, Ayda; Turkoz, Riza; Sasmazel, Ahmet; Karaci, Ali Riza; Cicek, Ali Ekber; Yalcinbas, Yusuf; Akcevin, Atif; Sarioglu, Tayyar; Bakir, IhsanThere is no standard for the selection of technical and mechanical components (heart-lung machine system, oxygenator, arterial and venous cannulae, arterial filter and other specifically-designed components and devices) used in cardiopulmonary bypass in Turkey. The cost of the component plays a significant role in the selection, as well as the preference of the facility. Only a limited number of hospitals decide which components to be used based on scientific data. Studies have confirmed that selected novel techniques and components having no basis of scientific justification may pose risk for the life of the patient in the short- and long-term. The objectives of this study are to show how to use quality-control procedures and scientific data for the selection of novel techniques and components and to share, also, recent techniques experienced to minimize the complication risk after surgery.Item Congenital heart surgery in Turkey(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2012-01-01) Undar, Akif; Bakir, Ihsan; Haydin, Sertac; Erek, Ersin; Odemis, Ender; Yivli, Perihan; Agirbasli, Mehmet; Alkan-Bozkaya, Tijen; Turkoz, Ayda; Turkoz, Riza; Sasmazel, Ahmet; Karaci, Ali Riza; Cicek, Ali Ekber; Yalcinbas, Yusuf K.; Akcevin, Atif; Sanoglu, TayyarItem Outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2020-01-01) Erek, Ersin; Aydin, Selim; Temur, Bahar; Onalan, Mehmet Akif; Suzan, Dilek; lyigun, Muzeyyen; Demi, lBrahim Halil; Odemis, EnderBackground: In this study. we present the outcomes of hybrid and Norwood Stage I procedures for the treatment of hypoplastic left heart syndrome and its variants. Methods: In this study, a total of 97 pediatric patients who were operated due to hypoplastic left heart syndrome and its variants between March 2011 and October 2018 were retrospectively analyzed. Thirty-two of the patients (28 males, 4 females: median age 5 days: range, 1 to 25 days) underwent Norwood Stage I operation (Group N). while the remaining 65 patients (44 males, 21 females: median age 6 days: range, 1 to 55 days) underwent a hybrid procedure (Group H). Both treatment strategies were compared. Results: The median body weight in Group H was significantly lower and the number of patients with a low birth weight (<2,500 g) was significantly higher than Group N (p=0.002 and 0.004. respectively). The postoperative early mortality rate was similar between the groups. Univariate and multivariate analyses revealed that the need for preoperative mechanical ventilation was a significant factor for mortality (p=0.004 and 0.003, respectively). Syndromic appearance was also a significant factor the multivariate analysis (p=0.03). There was a statistically significant difference between the groups in terms of the inter-stage mortality rates (p=0.0045). Second-stage procedure was performed in 32 patients. The early mortality rate after the Glenn operation was 7.6\%. Six patients died after comprehensive Stage II operation. Five patients underwent biventricular repair and 8 patients had third-stage fenestrated extracardiac Fontan operation (Group N, n=7 and Group H. n=1). The Kaplan-Meier survival curve demonstrated that Group N had a higher survival rate at both one and five years than Group II. although the difference was not statistically significant (p=0.15). Subgroup analysis showed that the Norwood procedure with Sano modification had the highest survival rate with 40\% at five years. Conclusion: Our study results show that patients undergoing the Norwood procedure have a more uneventful course of inter-stage period and Stage II and III. despite drawbacks early after Stage I procedure. Based on our experiences, we recommend performing the hybrid intervention in patients with a poor clinical condition and a body weight of <2.500 g.Item Incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2019-01-01) Erek, Ersin; Suzan, Dilek; Aydin, Selim; Hesenov, Ramal; Temur, Bahar; Kirat, Bans; Yildiz, Okan; Demir, Ibrahim Halil; Odemis, EnderBackground: In this study, we aimed to investigate the incidence and treatment of pulmonary vein stenosis after repair of total anomalous pulmonary venous connection. Methods: Between December 2010 and December 2016, a total of 40 patients (25 males, 15 femalesItem Levoatriocardinal vein with normal intracardiac anatomy and pulmonary venous return(MEDKNOW PUBLICATIONS \& MEDIA PVT LTD, 2011-01-01) Odemis, Ender; Akdeniz, Celal; Saygili, Ozlem Barutcu; Karaci, Ali RizaLevoatriocardinal vein (LACV) is characterized by an abnormal connection between pulmonary and systemic venous return. This extremely rare cardiac malformation is usually associated with left-sided obstructive lesions including mitral atresia, hypoplastic left-heart syndrome, and abnormal pulmonary venous connection. Patients may have low systemic cardiac output and pulmonary venous obstruction symptoms. In this manuscript, we report a case with LACV and normal pulmonary venous return with absence of any intracardiac pathology. LACV was demonstrated with echocardiography, angiography, and computed tomography. Surgical correction was made successfully.Item Outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of great arteries and ventricular septal defect(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2019-01-01) Erek, Ersin; Suzan, Dilek; Aydin, Selim; Yildiz, Okan; Kirat, Baris; Demir, I. Halil; Odemis, EnderBackground: This study aims to present the outcomes of arterial switch operation for Taussig-Bing anomaly versus transposition of the great arteries and ventricular septal defect. Methods: Between November 2010 and December 2 016, a total of 100 consecutive arterial switch operations in 42 pediatric patients (25 males, 17 femalesItem The effect of intravenous iloprost on pulmonary artery hypertension after paediatric congenital heart surgery(OXFORD UNIV PRESS, 2016-01-01) Onan, Ismihan Selen; Ozturk, Erkut; Yildiz, Okan; Altin, Husnu Firat; Odemis, Ender; Erek, ErsinOBJECTIVES: To investigate the effects of intravenous iloprost on pulmonary artery hypertension (PAH) in infants undergoing congenital heart surgery. METHODS: In this prospective, randomized study, the study group (n = 15) received a continuous infusion of iloprost (2.0 ng/kg/min) that was delivered immediately after weaning from cardiopulmonary bypass and continued for 72 h postoperatively. Patients in the control group (n = 12) were managed conventionally. The groups were compared in terms of postoperative data, including systolic and mean pulmonary artery (PA) pressures, PA/systemic pressure ratio, lactate level, PAH crisis, ventilation time, reintubation and lengths of intensive care unit (ICU) and hospital stay. Transthoracic echocardiography was used to assess PA pressures at 1 day, 7 days and 30 days after surgery. RESULTS: No mortality occurred. PAH crisis occurred in 2 (16.6\%) patients in the control group and 4 (26.7\%) patients in the study group (P = 0.53). Postoperative PA pressures and PA/systemic pressure ratios were similar between the groups (P > 0.05). The durations of ICU (P = 0.40) and hospital (P = 0.98) stays were similar between the groups. Echocardiographic studies demonstrated a significant decrease in postoperative PA pressures in the control (P = 0.001) and study (P = 0.0001) groups. However, no significant change was observed between the groups (P > 0.05). The Tukey multiple comparison test showed a significant decrease in PA pressures at each follow-up in both groups (P < 0.05). CONCLUSIONS: Intravenous iloprost demonstrated no additional benefit over the conventional management of infants with PAH after repair of intracardiac defects. Clinicians may prefer other alternative agents in infants with a high risk of PAH crisis.Item A rare cause of cyanosis in childhood: Pulmonary arteriovenous malformation(TURKISH SOC CARDIOLOGY, 2017-01-01) Guvenc, Osman; Saygi, Murat; Demir, Ibrahim Halil; Odemis, EnderPulmonary arteriovenous malformation, which is defined as the presence of an abnormal connection between the pulmonary artery and pulmonary vein, is rarely seen. Although it generally presents as a congenital condition, it may be accompanied by hereditary hemorrhagic telangiectasia. Clinical signs vary according to the amount of shunt in proportion to the number and size of the fistulae. Patients may present with cyanosis and respiratory trouble. If the disease remains untreated, it may result in cardiac failure and infective endocarditis, thereby leading to the rupture of the aneurysmal fistula. Transcatheter embolization of abnormal vascular connection is the current treatment method in this disease. This article describes the case of an 8-year-old child. He was presented with the symptom of getting tired quickly. Transcutaneous oxygen saturation of 75\%, and pulmonary arteriovenous malformation were detected in his examination. Successful transcatheter embolization of the fistula was performed.Item Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in children after cardiac surgery(TURKISH SOC CARDIOLOGY, 2017-01-01) Erek, Ersin; Aydin, Selim; Suzan, Dilek; Yildiz, Okan; Altin, Firat; Kirat, Baris; Demir, Ibrahim Halil; Odemis, EnderObjective: Extracorporeal membrane oxygenation (ECMO) is used to provide cardiorespiratory support during cardiopulmonary resuscitation (extracorporeal cardiopulmonary resuscitationItem Rare combination and transcatheter treatment during single session in an infant: Patent ductus arteriosus and major aortopulmonary collateral artery concordance(TURKISH SOC CARDIOLOGY, 2016-01-01) Guvenc, Osman; Odemis, Ender; Saygi, Murat; Demir, Ibrahim HalilMajor aortopulmonary collateral arteries are abnormal vascular structures that may be seen in cyanotic diseases that progress with reduced pulmonary flow. They occur rather rarely in the absence of cyanotic congenital heart disease. Presently described is the case of an infant who underwent patent ductus arteriosus (PDA) and major aortopulmonary collateral artery occlusion in a single session, without presence of cyanotic congenital heart disease. To the best of our knowledge, this is the first case of congenital aortopulmonary collateral artery to be reported in a symptomatic infant with PDA.